University of Rochester Specialty A/R Associate - 218414 in Rochester, New York
Specialty A/R Associate
Medical Faculty Group
Full Time 40 hours Grade 009 United Business Office NE
The Specialty A/R associate will handle all functions associated with the resolution of an exclusive set of complex accounts. The tasks in specialty billing will be workflow driven and the associate will be expected to research, retain and make suggestions to optimize key performance in collections in this area.
Resolves system edits; unpaid and denied insurance/client accounts, resulting in payment or resolution of the outstanding claim. The Specialty A/R associate will utilize MFG and/or payer billing software and will adhere to documented policies, procedures and workflows related to billing and collection.
With general direction of the Manager and with latitude for initiative and judgment:
Utilizes A/R experience and knowledge of billing software system, third party payer requirement and insurance regulation to resolve complex accounts in specialty billing. Researches and makes suggestions to optimize key performance in the resolution of Pre-A/R and Accounts Receivable. Prioritizes work queues efficiently and effectively based on the designated workflow.
Researches claims, identify problems and take appropriate action to assure claim resolution. Recognize trends within various areas of specialized billing and bring forth suggestions/solutions to the problem working with other teams and/or the department when necessary.
Follows up on ‘non-routine’ denied accounts through review of remittances (EOBs), insurance correspondence, rejections received thru daily electronic claims submission, etc. Communicates with insurance representatives through telephone calls, payer website, and in written communication Mails paper claims with appropriate attachments when needed (insurance EOB, medical records, etc.). Ensures additional documentation and/or information is provided for claims.
Prepares reports for management to document recurring problems and identifies the source of reimbursement delays. Works closely with management to ensure effective communication to resolve invoice payment delays.
Verifies correct patient demographic information, guarantor account and completes insurance pre-verification utilizing payer website. The Specialty AR associate will communicate any missing/incomplete information to their manager to if a charge is lacking any information to be sent out correctly.
Completes special projects as assigned.
Associate’s degree in business field and 4-5 years experience in hospital billing, accounting, and/or coding; or an equivalent combination of education and experience
Demonstrated organizational and problem-solving skills
Effective written and verbal communication skills
Strong working knowledge of the professional billing software applications
Strong analytical skills
Knowledge of Microsoft Office programs (Word, Excel etc.)